Objectives: To describe the incidence and outcomes of pulmonary oedema in women with severe maternal outcome during childbirth and identify possible modifiable factors through audit.Methods: All... Show moreObjectives: To describe the incidence and outcomes of pulmonary oedema in women with severe maternal outcome during childbirth and identify possible modifiable factors through audit.Methods: All women with severe maternal outcome (maternal deaths or near misses) who were referred to Tygerberg referral hospital from health facilities in Metro East district, South Africa, during 2014-2015 were included. Women with severe maternal outcome and pulmonary oedema during pregnancy or childbirth were evaluated using three types of critical incident audit: criterion-based case review by one consultant gynaecologist, monodisciplinary critical incident audit by a team of gynaecologists, multidisciplinary audit with expert review from anaesthesiologists and cardiologists.Results: Of 32,161 pregnant women who gave birth in the study period, 399 (1.2%) women had severe maternal outcome and 72/399 (18.1%) had pulmonary oedema with a case fatality rate of 5.6% (4/72). Critical incident audit demonstrated that pre-eclampsia/HELLP-syndrome and chronic hypertension were the main conditions underlying pulmonary oedema (44/72, 61.1%). Administration of volumes of intravenous fluids in already sick women, undiagnosed underlying cardiac illness, administration of magnesium sulphate as part of pre-eclampsia management and oxytocin for augmentation of labour were identified as possible contributors to the pathophysiology of pulmonary oedema. Women-related factors (improved antenatal care attendance) and health care-related factors (earlier diagnosis and management) would potentially have improved maternal outcome.Conclusions: Although pulmonary oedema in pregnancy is rare, among women with severe maternal outcome a considerable proportion had pulmonary oedema (18.1%). Audit identified options for prevention of pulmonary oedema and improved outcome. These included early detection and management of preeclampsia with close monitoring of fluid intake and cardiac evaluation in case of suspected pulmonary oedema. Therefore, a multidisciplinary clinical approach is recommended. Show less
A little-known feature of the vast migrant labour system that supplied South Africa’s gold-mining industry was the Deferred Pay Interest Fund. For much of the 20th century, a portion of the wages... Show moreA little-known feature of the vast migrant labour system that supplied South Africa’s gold-mining industry was the Deferred Pay Interest Fund. For much of the 20th century, a portion of the wages owed to African mine workers was deferred and remitted to them only at the end of their contracts. This is well-known, but what happened to the interest that accumulated on these deferred wages remains virtually unknown. Mine workers did not receive this interest; it was, instead, deposited into a fund controlled by the mining industry. This article examines the operations of this fund in the Transkei in the context of the crisis in the migrant labour system precipitated by newly independent states refusing to supply further migrant labour to South Africa. This prompted the Chamber of Mines to reorient labour recruitment towards the South African bantustans, and the Transkei quickly became the most important source of labour for the mines in the 1970s and 1980s. Although the fund had a mandate to spend on welfare projects in labour-sending regions, we argue that patterns of spending clearly show how it was used to support the reproduction of the migrant labour system. Payments were used as patronage for local elites, upon whom recruitment depended, and for distributing propaganda for the mining industry. In contrast, payments were consistently directed away from education for able-bodied students, because education would reduce the pool of unskilled labour on which the gold industry relied. Money that, arguably, rightfully belonged to mine workers from the Transkei was used to perpetuate their dependence upon migrant labour to the mines. Show less
In terms of national politics, the UDF focused on protest against apartheid and on popularizing the programme and leadership of the banned ANC, simultaneously developing an increasingly radical... Show moreIn terms of national politics, the UDF focused on protest against apartheid and on popularizing the programme and leadership of the banned ANC, simultaneously developing an increasingly radical agenda for social change in South Africa. But how was the political programme of the UDF understood in the social and moral universe of divergent local communities? This paper explores how the antiapartheid struggle in the 1980s was understood in three locally-based social movements that campaigned under the banner of the UDF, viz. a rural youth movement (Sekhukhuneland), a civic association in an African township (Kagiso), and a community newspaper ('Grassroots') in Cape Town. Seen from the vantage point of local case studies, several sub-themes emerge behind the overall theme of the antiapartheid struggle, notably the importance of religion and local belief systems, and the reversal of generational roles which expressed itself in the contestation of patterns of authority within African society itself. The paper is largely based on the author's book on the UDF (2000), which is an adaption of her PhD thesis (1995) for which field work was carried out in 1990-1991. Show less
Met enige regelmaat verkondigen Afrikaanse politici en intellectuelen de komst van een 'Afrikaanse Renaissance'. Thabo Mbeki maakte de Afrikaanse Renaissance tot het handelsmerk van zijn regering,... Show moreMet enige regelmaat verkondigen Afrikaanse politici en intellectuelen de komst van een 'Afrikaanse Renaissance'. Thabo Mbeki maakte de Afrikaanse Renaissance tot het handelsmerk van zijn regering, maar de reikwijdte van het begrip is niet beperkt tot Zuid-Afrika. Voor de meeste pleitbezorgers heeft de Afrikaanse Renaissance een panafrikaanse dimensie. Het begrip is niet alleen inzetbaar voor doeleinden als marketing en morele generatie, het dekt ook uiteenlopende ideologische ladingen, zoals modernisering, traditionalisering en afrikanisering. In de visie van Mbeki heeft Afrika vooral behoefte aan een grootscheeps moderniseringsprogramma om te ontkomen aan marginalisering op het wereldtoneel. Traditionele 'chiefs' die vrezen dat hun machtspositie wordt ondermijnd, beroepen zich op een Afrikaanse Renaissance die de waarden van prekoloniaal Afrika moet herstellen. Politieke en economische elites, gedesillusioneerd over het trage veranderingsproces in Zuid-Afrika, hijsen de vlag van de Afrikaanse Renaissance om een versnelde afrikanisering af te dwingen. Een centrale vraag in de discussie is wie onder de noemer 'Afrikaan' valt. Mbeki schetst weliswaar een inclusief beeld van Afrika en Afrikanen, maar veel Renaissance-adepten gaan er van uit dat de Renaissance all‚‚n geldt voor zwarte (Zuid)Afrikanen. Noten, samenv. in het Engels (p. 227) Show less
The 1980s were a dramatic period in the history of South Africa. At stake in the battles of the 1980s was the contest about changing the borderlines in the racial and social stratifications of the... Show moreThe 1980s were a dramatic period in the history of South Africa. At stake in the battles of the 1980s was the contest about changing the borderlines in the racial and social stratifications of the country. In this contest, participants developed their own visions of a future society, of a new political and social order as well as a new moral order. This book examines these processes at the local level. It focuses on the United Democratic Front (UDF) as a social movement from below, officially launched in August 1983. The aim of the UDF was the creation of a united democratic South Africa. The author takes three local organizations as a vantage point. The first part of the book briefly explores the origins of the UDF, followed by a chronological outline of major events and trends in the 1980s. The second part consists of three case studies, which look in detail at locally based attempts at shaping a new society: a youth congress in Sekhukhuneland, a rural part of Lebowa in the Northern Transvaal; a civic association in Kagiso, a township west of Johannesburg; and 'Grassroots', a community newspaper in the Cape Peninsula. The conclusion describes how these local struggles fit into the overall story of the antiapartheid struggle Show less
The revival of popular protest against South Africa's apartheid in the first half of the 1980s was also marked by a proliferation of new mass media. This chapter presents a case study of ... Show moreThe revival of popular protest against South Africa's apartheid in the first half of the 1980s was also marked by a proliferation of new mass media. This chapter presents a case study of 'Grassroots', a publication aimed at a Coloured and African readership in the Cape Peninsula, launched in 1980. The author shows how the newspaper chronicled "the everyday struggles of ordinary people" - ranging from demanding more washing lines to rising costs of living, unemployment benefits, and the history of past struggles. Those who worked for the journal did not see themselves primarily as journalists but as community activists. The author discusses the contradictions within this community - the 'racial divide' between Africans and Coloureds, as well as the "ideological, religious, linguistic, generational and socioeconomic" fault lines. The newspaper's project was to raise political awareness and build bridges across these divides, and to function as a catalyst between the interests of local and national organizations associated with the UDF and the wider Charterist movement. The newspaper was shut down in 1990. It shared the fate of most of the alternative newspapers, which did not manage to evolve a new formula to survive in the new conditions. Notes, ref Show less
